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Menopause and Brain Health

May 18, 2024 | The Healthy Way Newsletter

We know that declining hormones impact brain health, and multiple studies support that.

Estradiol is the primary source of estrogen that works on the brain. It directly relates to changes in memory performance and the reorganization of brain circuitry that regulates memory function. For women, reproductive aging is more critical than chronological aging. Women with other medical conditions such as Diabetes and Hypertension are at an increased risk of cognitive decline. 

Menopause is commonly linked to the ovaries, but symptoms like hot flashes, night sweats, insomnia, memory issues, depression, and anxiety actually start in the brain. These symptoms are neurological in nature, but we often overlook this perspective.

How is the brain affected in menopause

One reason why menopause impacts the brain is because estrogen (estradiol in particular), the main female hormone, is involved not only with reproduction but also with brain function.

When estrogen levels start to fluctuate widely during perimenopause years and then drop off with menopause – there is a significant effect on the brain. Fortunately, these changes are temporary and do not affect cognitive performance. Women may be tired but we are just as sharp as before. 

What is the impact

1. Hot flashes are a common occurrence during perimenopause and are linked to the functioning of the hypothalamus. The hypothalamus is a small region in the brain that plays a crucial role in regulating various bodily functions, including regulating body temperature, and when estrogen fails to activate the hypothalamus properly, it can lead to hot flashes and night sweats.

2. Sleep Problems: A similar process occurs in the brain stem, which serves as the command center for the body’s sleep and wake cycles. When estrogen fails to properly activate the brain stem, it can lead to difficulties with sleeping and disruptions in sleep patterns.

3. Mood Changes: The amygdala, a brain region linked to emotional functions, is situated in the medial temporal lobe, in front of the hippocampus, and is a paired structure found in each hemisphere of the brain. It forms part of the limbic system, a neural network involved in regulating emotions and memory processes.
Estrogen, a hormone primarily associated with reproductive functions, has been found to influence the structure and function of the amygdala. Research suggests that estrogen can modulate amygdala activity, affecting emotional responses, social behavior, and memory processes. Estrogen receptors are present in the amygdala, indicating a direct link between estrogen signaling and amygdala function. Diminished estrogen here can contribute to mood swings, depression, or anxiety.

4. Forgetfulness may be linked to lower estrogen levels in the hippocampus. The hippocampus is a part of the brain that is involved in memory formation and spatial navigation. It plays a crucial role in the consolidation of information from short-term memory to long-term memory and is also important for learning and emotional regulation. The hippocampus is located in the medial temporal lobe and is essential for forming new memories and recalling past experiences.

5. Brain fog, a common experience during perimenopause, is a temporary transition that can be supported and resolved as the brain adjusts to decreased estrogen levels.

Alzheimer’s disease and menopause

For some women, the withdrawal of estrogen in perimenopause can have a more serious effect, setting the stage for Alzheimer’s disease later in life. Almost 2/3 of all Alzheimer’s cases are women. Women live longer than men overall, giving them more time to develop Alzheimer’s, but the gender longevity gap doesn’t fully explain the disparity.

Estrogen pushes neurons to burn glucose to make energy. If your estrogen is high, your brain energy is high. When your estrogen declines, your neurons start slowing down and age faster. Studies have shown that this process can lead to the formation of amyloid plaques, which are a hallmark of Alzheimer’s disease.” It must be noted that not all women develop plaque and not all women with plaque develop Dementia.

Perimenopause appears to activate the formation of plaque in some women who have a genetic predisposition. Those who have 1st-degree members with the disease or who carry a gene known as APOE4 are at an increased risk.

The good news is there are multiple ways to improve your brain health and lower your chances for Alzheimer’s disease and other forms of dementia. This includes a variety of factors, from diet and exercise to sleep, stress reduction, and reduced exposure to toxins, including chemicals found in things like plastics and pesticides.

How to support and protect the brain as you age


The Mediterranean diet seems to work best for slowing brain aging.  Research has shown that the brain of a 60-year-old woman on the Mediterranean diet looks five years younger than that of a 50-year-old woman on the Western diet. The diet is high in fruits and vegetables, nuts, seeds, fish, and olive oil. Disease-fighting antioxidants found in berries and citrus fruits promote a healthier brain.

Reduce stress

Exercise also helps to lower stress, another barrier to good brain health. Brain imaging studies are showing that women’s brains are actually more vulnerable to chronic stress than men’s brains. Meditation or yoga also can also lower stress.


Physical activity helps both men and women prevent dementia. It seems to be of greater benefit to women. Vigorous exercise seems to be best – you need to sweat when you work out.

Stay cognitively and socially active

Engaging in cognitive and social activities during menopause can help support brain health by stimulating mental processes, enhancing memory, and reducing the risk of cognitive decline. These activities can also provide emotional support, reduce stress, and improve overall well-being during this transitional phase of life. The combination of cognitive and social engagement can help promote brain plasticity and resilience, which are important for maintaining cognitive function as you age.


Adequate sleep – currently suggested as 7 hours a night is critical for brain health. Research suggests that during certain phases of sleep-learning is consolidated, glymphatic circulation also helps clear debris from our brain and works mainly at night. This biological “brainwashing” happens while you sleep and is important for filtering out toxins. That is why one of my healing pillars is always body and brain detoxification. I assess my patients for environmental toxins and toxic metals routinely as part of all my longevity protocols.

Can hormone replacement treatment help

Research shows that timing matters. Starting HRT in perimenopause (4-8 years before menopause) or early menopause may have a positive effect on brain activity and memory function. Additional studies are necessary to establish the most effective route, dose and timing of administration: most of the research to date has been conducted on healthy women and little is known about the impact on women who also suffer from diabetes and hypertension.

Although more research is needed, the time to start incorporating what we already know is now.

Toronto Naturopathic Clinic offers a variety of programs dedicated to healthy aging and hormonal disbalance restoration.

Book your first appointment today and start your healthy journey with us.

About Me

I'm Dr. Elena Krasnov, N.D and I've been healing people for decades with my holistic and comprehensive approach to health.

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